Taken together, these studies suggest that APOE-ɛ4 genetic status21-27 and higher AD-PRS scores21,24,26,28,29 are both associated with lower volumes or thickness of Alzheimer’s disease-vulnerable regions, with higher rates of atrophy in these regions,18,30-36 and with higher levels of37-41 and greater increases in WMH burden over time27,42,43 (but see Tank et al.,24 Habes et al.,44 Lyall et al.,45 Lane et al. 46 and Debette et al. 47). Here, APOE is linked to early-onset autosomal dominant Alzheimer disease.